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Revista Oficial de la Universidad Biomédica Rafael Guízar y Valencia A. C.

2003, Number 2

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Plasticidad y Restauración Neurológica 2003; 2 (2)

Trigeminal Neuralgia. One problem, many options of treatment

Revuelta GR, Escobedo RF, Arvizu SE, Juambelz CPP, Fernández AB

Language: Spanish
References: 45
Page: 97-102
PDF size: 136.16 Kb.


ABSTRACT

This paper is based on the study and management of over 800 patients in the last 20 years at the Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suarez” in Mexico City and Hospital Español de México. After having managed the different procedures below mentioned we believe that microvascular decompression is the ideal procedure since it is not destructive; currently is made with minimum invasion and good results. Trigeminal neuralgia is an entity characterized by paroxistic, repetitive, and brief duration pain, localized in one or more branches of the nerve, unchained by an external stimulus on a “trigger” point. The initial treatment has to be by medication and carbamazepine is that brings better results, even on occasions it is used as therapeutic proof, however it is frequent that along the patient’s evolution the dose required for controlling the pain has to be more and more high and this on occasions is associated with adverse effects not ever tolerated by the patients. Diverse procedures have been developed directed to relief the pain. In general term these are: 1) destructive procedures (physical or chemical) and 2) non-destructive procedures. Non-destructive procedure is the microvascular decompression of the trigeminal root at the posterior fosse and that is because has to be considered the procedure that currently is nearest to the ideal. The surgical indications in trigeminal neuralgia are: 1) secondary trigeminal neuralgia, and 2) trigeminal neuralgia with poor response to medication or intolerance to it.


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